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Oregon Occupational Injury and Illness Survey Tables and Appendices Calendar Year 2004 Information Management Division Oregon Department of Consumer & Business Services April 2006 CY 2004 OREGON OCCUPATIONAL
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How to fill out Oregon Occupational Injury and?

01
Obtain the form: Start by acquiring the Oregon Occupational Injury and form. This form may be available online on the Oregon Workers' Compensation Division website or from your employer's human resources department.
02
Provide personal information: Begin by filling in your personal details such as your full name, social security number, address, and contact information. Ensure that all information is accurate and up to date.
03
Specify the employer: Indicate the name and address of your employer. This includes the company or organization you work for, as well as their contact information.
04
Describe the injury: Explain the details of your injury or illness. Include information such as the date and time it occurred, the location where it happened, and a concise description of what transpired.
05
Outline the medical treatment: Provide information regarding the medical treatment you have received, including the name and address of the healthcare provider, the dates of treatment, and any medications or procedures involved.
06
State the witnesses: If there were any witnesses to the incident, provide their names, contact information, and a brief statement about what they saw or know regarding the injury.
07
Clarify time away from work: If your injury resulted in time away from work, indicate the dates when you were unable to perform your job duties. This includes any lost wages or sick leave used during this period.
08
Submit the form: Once you have completed all the necessary sections of the form, sign and date it. Keep a copy for your records and submit the form to the appropriate party, such as your employer's HR department or the Workers' Compensation Division.

Who needs Oregon Occupational Injury and?

01
Employees in Oregon: Any individual who is employed in the state of Oregon and experiences an occupational injury or illness should complete the Oregon Occupational Injury and form.
02
Employers: Employers in Oregon are responsible for providing their employees with the necessary forms and resources to report workplace injuries and illnesses. They may need the completed form for record-keeping, workers' compensation, or insurance purposes.
03
Healthcare providers: Medical professionals who treat individuals with occupational injuries or illnesses may request the completed Oregon Occupational Injury and form for documentation purposes or to assist in the patient's workers' compensation claim.
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Oregon occupational injury and is a report that must be filed by employers in Oregon to report any workplace injuries or illnesses.
All employers in Oregon are required to file oregon occupational injury and.
The oregon occupational injury and report can be filled out online through the Oregon OSHA website or by submitting a paper form.
The purpose of oregon occupational injury and is to track and analyze workplace injuries and illnesses to improve workplace safety and prevent future incidents.
Employers must report all workplace injuries and illnesses, including the date of the incident, the nature of the injury or illness, and the name of the affected employee.
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